EAST AFRICAN INTERNATIONAL COLLEGE

PROVIDE COMPASSIONATE , RESPECTFUL

AND CARING SERVICE

BY; TSEGAAB Y

CRC by Tsegaab Y 08/31/2020

 Learning Objectives

 At the end of this chapter the student will be able to:

 Apply professionalism and ethical practice principles
 Apply humanistic care to clients
 Demonstrate effective health care communication
 Provide respectful care for clients
 Function with legal and ethical framework through
responsibility and accountability

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 CHAPTER 1

APPLYING PROFESSIONALISM AND ETHICAL PRACTICE

PRINCIPLES
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1.1 Over view of Pharmaceutical ethics

WHAT IS ETHICS?
 The term ethics derived from the Ancient Greek word ethikos,
which is derived from the word ethos (habit, “custom”).
 Ethics is the systematic study of what is right and good with
respect to conduct and character.
 It refers to a method of inquiry that assists people to understand
the morality of human behavior. (i.e. it is the study of morality).
 Ethics refers to the practices or beliefs of a certain group (i.e.
nursing ethics, Physicians' ethics and pharmacy ethics).
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 Ethical principles and moral rules…

 Nonmaleficence is the converse of beneficence. It

means to avoid doing harm.
 Justice is fair, equitable and appropriate treatment
 Veracity means telling the truth, which is essential to
the integrity of the client-provider relationship
 Fidelity means being faithful to one's commitments and
promises
 Confidentiality is the requirement of health
professionals (HPs) to keep information obtained in the
course of their work
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 Vocation-is an occupation to which a person is

specially drawn or for which they are suited, trained,
or qualified
 Professional ethics encompass the personal,
organizational and corporate standards of
behaviour expected of professionals.

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 HISTORY AND DEVELOPMENT OF PHARMACEUTICAL ETHICS

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 RIGHTS AND OBLIGATIONS OF PHARMACY VOCATIONAL

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 Enter and maintain prescription data using our computer system

 Answer incoming phone calls and field patient questions

 Contact doctor’s offices or hospitals to clarify prescription

information
 Disburse completed and confirmed prescriptions to patients

 Answer patient questions and address customer service issues

when they arise

 Assist the pharmacist with maintaining the ongoing medication

inventory and place medication orders when instructed

 
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 Qualities / Components of Ethical behaviour
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 Confidentiality means keeping the patient

related information's secret. But there are times
when the pharmacist or other practitioners may
unfold the information. E.g. If the patient is
willing, If unfolding the information is much better
or useful to the society than otherwise.
 Adaptability: Is the ability to adjust oneself
to new or changed circumstances/conditions

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 Components…
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 Cooperation: Is a co-working system; The work

of pharmacy is insignificant unless it is augmented
by other health practitioners. Therefore health
practice must be team work.
 Dependability: This is a condition in which one
develops to depend on others. In health practice
there are more things to learn from people who
have a lot of experience

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 Components…
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 Honest (Being loyal) : For the people to be beneficiary

and activities to be accomplished successfully being an
honest is the primary asset to achieve
 Responsibility: Is the condition or the fact that one
can shoulder obligations
 Accountability: Is the condition or fact that one can
be called to answer for his wrong doings
 Transparency: This is a case in which things must run
by the book (based on rules, regulations etc.) rather
than by what is comfortable and beneficial to one self.
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 Components…
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 Humanity: is a virtue associated with basic ethics

of altruism derived from human condition.
 Kindness is a behavior marked by ethical
characteristics, a pleasant disposition and concern and
consideration for others.
 Firmness is to make an agreement.
 Maintaining good report: It is important to prepare
good report on the activities performed at each level

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 Components of unethical behavior
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Components of unethical behavior

 Corruption – dishonest
 Smuggling : move goods illegally into or out of a
country.
 Mistreating the patient
 Behavioral
 Theft
 Drug dependence
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 Ethiopian pharmaceutical code of ethics
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 Code of ethics is based on the moral obligations

and designed to establish guidelines for
professional ethical behaviour.
 A code of ethics for a health professional is a
system of principles intended to govern behaviour
of those entrusted with providing care to the sick.
 Pharmacists are health professionals who assist
individuals in making the best use of medications.

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 Code of ethics…
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 The main body of code of ethics has been subdivided

into the following three sections:
 Ethical principles and obligations of the pharmacist
with respect to other stake holders during his/her
professional practice. E.g. parents, public, health
professional
 Ethical principles and standards in Pharmacy practices
 Ethical principles and Obligations on Special Ethical
Issues e.g. abortion

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 Ethical standards of practice in Ethiopia
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 Ethical standard during dispensing of medication in

pharmacy
 Personally fill all prescriptions or ensure
appropriate filling or orders
 Accept prescription only in writing except under
an emergency or compelling conditions
 Ensure that medicines and health care products are
approved for sale
 Not dispense Prescription only drugs without
prescriptions. CRC by Tsegaab Y 08/31/2020
 Con’t…
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 Inform the prescriber for due correction or

clarification
 Not dispense both prescription &/or OTC drugs

to patients who are apparently not in their right

mental state
 Promote that medicines would be dispensed as

original packs
 Ethically free to make generic substitution of

prescription drugs
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 Con’t…
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 Provide an effective and accurate patient

education and counselling
 Know his/her patients with regard to cultures

 Give ample verbal and written information

 Ensure about the comfortable environment for

counselling
 Ensure about the design and layout of the

pharmacy
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 Con’t…
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 Ensure the external appearance of the

pharmacy
 Make arrangements to ease services available

to disabled persons
 Not supply any medicinal product to a child

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 Prescription handling
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 Prescription handling: Prescriptions should be properly

documented so that they can be used for auditing,
reporting on drug use, and to make investigation on
which drugs have been dispensed to a patient.

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 Patient counselling
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 The process of advising

patients about their
medicines, including
what the medicine is
for, how and when to
take it, what side-
effects to expect and
what to do if they
occur.

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 Aims of patient counselling
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 In addition to the provision of advice from the

pharmacist could be to:
 Encourage patients to identify any problems they
perceive with medicines and also any solutions to these
problems
 Encourage patients to develop their own action plan for
taking/using medicines correctly
 Gain an understanding of the patient’s perspective
 Respect the patient’s beliefs and be non-judgemental of
their use (or non-use) of medicines
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 Opportunities of counseling
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 Pharmacist – Last HCP before starting drug therapy

 Patient counselling in community pharmacy –
Integral part of the dispensing
 Counselling needs an up-to-date information.
 Sources for counselling are prescription,
medication leaflets, computer-aided counselling
systems

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 How to counsel

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 The community pharmacists must possess not only sound

knowledge of the drugs and appliances being dispensed or sold, but
also excellent communication skills.
 Pharmacist must have the ability to explain information clearly and
unambiguously and in language the recipient can understand.
 To make counselling process successful, it must be a two-way
process. There should be ample opportunity for the patient to ask
questions.
 Importantly pharmacist should know how to listen and building a
rapport
 Introduce aids to comprehension e.g., explanatory leaflet or
diagram, a placebo device CRC by Tsegaab Y 08/31/2020
 What information to include in counselling
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 How much and how often to take the medicine

 When to take the medicine
 How long the treatment is to last
 How to take the medicine
 How to store the medicine
 Not to share medicines with other persons
 Which types of foods and beverages should avoid
 To keep medicines out of reach of children
 Special care in case of inhaled administration and suppository application
 Also be informed not to stop treatment when side effects occur or in the
absence of response without consulting the prescriber or dispenser.
 Finally, check whether patients haveCRC
understood the information provided
by Tsegaab Y 08/31/2020
 Aids to counselling
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 Patient information leaflets, warning cards and

placebo devices are all useful aids when giving
advice to patients. Many medicines are available in
manufacturer’s original packs complete with a
patient information leaflet (PIL). These PILs should
be used during counseling where appropriate and
important points highlighted. Placebo devices, e.g.,
inhalers, patches etc., can be used demonstrate a
particular technique and also to check a patient’s
ability to use a device.
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 Minimum standards for pharmacy premises,
facilities and equipment

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 Appearance of pharmacy premises

 Design and layout:
 Should permit logical flow of work, effective
communication and supervision
 Ensure effective cleaning and maintenance
 Minimize the risk of errors, cross contamination
and anything else which would have an adverse
effect on the quality of products

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 Appearance of pharmacy premises…
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 All parts of the premises must be maintained in an

orderly and tidy condition
 The external appearance of the pharmacy must
portray a professional image
 Entrances, dispensing counters and doorways must
be accessible to disabled persons

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 Security in pharmacy premises

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 Careful consideration must be given to the overall

security of the pharmacy
 Access to a pharmacy when it is locked
 Control of access to medicine

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 Safety of pharmacy premises
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 Working conditions
 Fire extinguisher
 Electrical equipment → safe and maintained
regularly
 A safety procedure

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 Condition of pharmacy premises

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 The walls, floors, windows, ceiling, woodwork

and all other parts of the premises → clean and
good order
 Countertops, shelves and walls →finished in a
smooth, washable and impermeable material
 Site of premises
 Far from areas or premises that can cause
contamination to the products and affect health
in general (e.g. public toilets, waste dump site, etc.)
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 Construction of pharmacy premises

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 Prevent floods and entry of insects, animals or

birds
 cleaned and disinfected
 Allows adequate lighting and air movement
 Ceiling:
 Type that minimizes effects of high temperatures
Adequate height

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 Environment in pharmacy premises

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 Products stored according to recommended

conditions
 Levels of heat, light, noise, ventilation, etc., must
exert no adverse effects on pharmaceutical stock as
well as personnel
 Suitable and effective means of heating or cooling,
lighting and ventilation
 Avoid background music or other broadcasts →
distraction
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 Hygiene in pharmacy premises

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 Regular program for cleaning premises

 Area for washing equipment and other utensils
(hot and cold tap water)
 Toilet facilities must be kept clean and in good
order
 Hand-washing facilities

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 Premises
 Dispensary
 Size vs. volume of prescriptions dispensed
 Should allow a safe and efficient flow of work
 Should allow effective communication and supervision
 Configuration of available space and space available
elsewhere for storage of stock
 Waiting area
 Comfortable seating must be provided
 Appropriate health-related literature must be provided
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 Ethiopian guideline: 25m² minimum for

dispensary and waiting area with shortest side
not less than 4 m.
 Suitability of dispensary
 The dispensary, its fittings and equipment must be
adequate and suitable for the purpose of dispensing

 The temperature in the dispensing area must be

maintained below 25°C
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Ethical standard during compounding and
manufacturing of pharmaceutical
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 Foster the triad relationship

 Make sure about authorized personnel involving in
the compounding
 Ensure that the compounding personnel are free
from any ailments
 Have written procedures for the compounding drug
products
 Have working procedures, cleaning
procedures/SOP
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 Handling of narcotics, psychotropic and
other dangerous drugs
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 Keep separate and strict security storage area

 Dispense through special prescription paper
approved by Drug regulatory authority
 Keep proper registration and submit records to the

control authorities
 Properly label, mark, store and dispense poisons

 Immediately report breakage, loss or theft

 Keep expired and damaged products separately

 Refrain from abuse of controlled substances

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